Sir James Munby said news coverage of his comments about the girl, X, had ‘had some effect’ on the speed of care being found for her.
Photograph: Judicial Office/PA

A suicidal 17-year-old girl is to be moved to a secure unit on Thursday after a senior judge warned that plans to release her because of a shortage of secure beds for mental health patients would leave “blood on our hands”.

But in his latest ruling in the case of the youngster known only as X, Sir James Munby was scathing that the decision to find her a bed only followed his outspoken warnings that a failure to do so could result in her taking her own life.

The president of the family court said that without his intervention last week, NHS England would have not acted as effectively or speedily.

“This, however, is not a matter for congratulation,” Munby added. “On the contrary, it is, of itself, yet further cause for concern. The provision of the care that someone like X needs should not be dependent upon judicial involvement, nor should someone like X be privileged just because her case comes before a very senior judge.”

The case of X has proved an embarrassment to the NHS and shines a light on the lack of resources to cope with the most extreme mental health cases where lives can be immediately at risk.

Munby himself wondered who else might be at risk as the country’s mental health system strains to deal with rising demand from young patients at a time when the supply of beds as not been able to keep up.

In his ruling, he added: “I emphasise this because a mass of informed, if anecdotal, opinion indicates that X’s is not an isolated case and that there are far too many young women in similar predicaments. How are they to be protected?”

X had been detained in a secure unit following a youth court order and was expected to be released in the middle of August. But following several “determined attempts” on her own life, staff at the unit, known as ZX, concluded the care plan to send her back to a community setting was “a suicide mission to a catastrophic level”. They thought she would kill herself within two days of release.

However, none of England’s 124 places in low secure units were currently available and there was a six-month waiting list even though X was due to be released within days.

In his first judgment last week Munby, president of the family division, issued a stark warning about the needs of X and said the inability to find care for her embarrassed the nation.

He wrote: “If, when in 11 days’ time she is released from ZX, we, the system, society, the state, are unable to provide X with the supportive and safe placement she so desperately needs, and if, in consequence, she is enabled to make another attempt on her life, then I can only say, with bleak emphasis: we will have blood on our hands.”

The senior judge ordered the judgement to be sent to Amber Rudd, the home secretary, Jeremy Hunt, the health secretary, Justine Greening, the education secretary and the secretary of state for justice, David Lidington, and it sparked a flurry of activity in the following hours and days among health officials who announced on Friday that they had found X a place.

Last week’s ruling also “prompted substantial coverage” in the media, Munby said in yesterday’s judgment. “It was, for example, the main front page story in both the Guardian and the i. This seems to have had some effect.”

On Monday morning, NHS England finally submitted a detailed plan to keep her in a low secure unit, by creating new beds from those in a psychiatric intensive care unit, instead of trying to care for her in the community. Munby has now approved the plan which also includes new funding for her care – which requires a three-to-one staff ratio.

Munby revealed how the secure facility where X is currently housed could no longer keep her and he said he accepted their case. The facility had told the judge it had already spent £125,200 on looking after the troubled girl in additional staffing and complained that the Youth Justice Board had failed to provide additional resources.

It said that since X arrived she has diverted staff to the extent that 13 of the 24 people who normally live there have complained the quality of care is in breach of their statutory rights. Three staff are also off sick with stress and anxiety from “unusual experiences these staff have observed with X”.

The NHS plan is now to move X this Thursday into a psychiatric intensive care unit temporarily awaiting the conversion of beds to the status of a low secure unit. The same staff will be looking after her in both environments. An agreement has also been made for NHS England to fund an extra package of care in order for her needs to be met, including treatment that will be recommended following a comprehensive assessment.

“This will also include dedicated staff to support her throughout her admission, therapy and treatment including psychological and pharmaceutical input,” according to Munby’s ruling.

When the plan to convert a psychiatric intensive care unit into a low secure unit was announced on Friday the move was welcomed by Prof Wendy Burn, president of the Royal College of Psychiatrists. But she said: “Securing the right support for others like X should not be, and cannot be, dependent on one of the highest judges in the land showcasing his outrage and frustration. We urgently need to devise a national strategy so that people with personality disorders are supported from their adolescence into adulthood.”

Munby agreed with this analysis on Monday saying in his judgement: “Quite so.”

NHS England declined to comment. But on Friday, when it said it had found a hospital to look after her. Dr Mike Prentice, NHS England’s medical director for its north of England region, said: “Following extensive assessments, the NHS has identified a bed for this young woman in a safe and appropriate care setting which will best meet her needs.”

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here